Nursing Practice: Theories and Therapies

Importance of Studying Theories

• Theories explain human behavior.
• Focus on influential psychological theories and treatments in psychiatric nursing.

Sigmund Freud's Theories

Levels of Psychological Awareness

• Conscious Level: Perceptions, memories, thoughts, and fantasies.
• Pre-Conscious Level: Just below the surface, easily retrievable thoughts.
• Unconscious Level: Deeply buried trauma and unresolved issues.

Personality Structure

• Id: Unconscious, impulsive, seeks tension discharge, illogical.
• Ego: Develops in early childhood, problem solver, reality tester.
• Superego: Develops between ages 3-5, moral component, seeks perfection.

Defense Mechanisms

• Unconscious methods to cope with painful thoughts and events.
• Examples include denial and distortion of reality.

Classic Psychoanalysis

• Focus on transference and countertransference.
• Transference: Patient transfers feelings to provider.
• Countertransference: Provider transfers feelings to patient.

Interpersonal Theories

Hildegard Peplau

• Influenced by Sullivan.
• Established therapeutic communication and self-awareness.
• Described levels of anxiety and interventions.

Behaviorism

Key Theorists

• Pavlov: Conditioning with stimuli (e.g., Pavlov's dog).
• Watson: Behavior learned through classical conditioning.
• Skinner: Operant conditioning with rewards and punishments.

Behavioral Therapy Techniques

• Modeling: Role model behavior to be imitated.
• Operant Conditioning: Positive reinforcement to increase behavior.
• Exposure Therapy: Gradual exposure to fears with relaxation techniques.
• Aversion Therapy: Pairing negative stimulus with behavior.
• Biofeedback: Control physiological responses to stress.

Cognitive Theories

Key Theorists

• Ellis: Rational emotive behavior therapy, eradicate irrational beliefs.
• Beck: Cognitive behavioral therapy, focuses on changing thinking patterns.

Humanistic Theories

Maslow's Hierarchy of Needs

• Focus on human potential and personal growth.
• Needs in order: Physiological, Safety, Love/Belonging, Esteem, Self-Actualization.
• Emphasizes on patient strengths and prioritizing nursing actions.

Conclusion

• Emphasis on understanding psychological theories for better nursing practice.
• Focus on patient-centered care and self-awareness in therapeutic relationships.